Abner O Rayapati MD LLC

Organization Active NPI Psychiatry Physician · Lexington, KY

NPI 1437879541 · NPPES record last updated Aug 30, 2022

Key facts

NPI
1437879541
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatry Physician 2084P0800X
Legal business name
ABNER O RAYAPATI MD LLC
Practice address
2220 Executive Dr Ste 102
Lexington, KY 40505-4871
Phone
(859) 737-0904
NPI assigned
Aug 30, 2022
Organization subpart
No

Authorized official

Name
David Carter
Title
Credentialing Manager
Phone
(859) 737-0904

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2331168Abner O Rayapati MD, LLC
2220 Executive Dr, Ste 102, Lexington, KY 40505
Certificate of waiverSep 25, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20231010002077 KY Part B Supplier - Clinic/Group Practice 4688033418 Receives reassigned benefits from 2 practitioners
Practice locations: Lexington, KY

National Provider Directory

Locations

2220 Executive Dr
Ste 102
Lexington, KY 40505
Phone (859) 309-2603

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084P0800X Yes

Addresses

Primary practice location

2220 Executive Dr Ste 102
Lexington, KY 40505-4871

Mailing address

2220 Executive Dr Ste 102
Lexington, KY 40505-4871

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address david@mpcg.org

Other providers in Lexington, KY

All providers in Lexington, KY · Psychiatry Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.